The effects of cryotherapy on perineal pain after childbirth: A systematic review and meta-analysis

Midwifery. 2020 Oct:89:102788. doi: 10.1016/j.midw.2020.102788. Epub 2020 Jun 25.

Abstract

Background: Most women experience perineal pain after childbirth. Sustained perineal pain affects mother's daily living. Various methods have been used to relieve postpartum perineal pain, such as cold or warm therapy, but the pain-control effects of cryotherapy are still controversial.

Aims: The purpose of this study was to verify the effectiveness of cryotherapy in relieving perineal pain in women after childbirth.

Methods: The researchers searched the CINAHL, Cochrane, EMBASE, PubMed, Korea Education and Research Information Service, NDSL, KoreaMed, LILACS and SciELO databases for studies to include in this review, and selected studies using PICO criteria. Methodological quality was assessed based on Cochrane's risk of bias 2 for randomized controlled trials. Data were analyzed with the Comprehensive Meta-Analysis program.

Findings: Eleven published studies encompassing 1,492 participants were included. Cryotherapy significantly reduced pain two days postpartum. Ice packs and gel packs had similar pain-relieving effects. Cryotherapy did not differ significantly from Epifoam therapy (hydrocortisone-pramoxine) in its effects on perineal pain one day or five days after childbirth.

Conclusions: Cryotherapy can be an effective non-pharmacological nursing intervention to reduce pain after childbirth.

Keywords: Cryotherapy; Pain; Perineum; Randomized controlled trial.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Cryotherapy / methods
  • Cryotherapy / standards*
  • Episiotomy / adverse effects
  • Episiotomy / psychology
  • Female
  • Humans
  • Pain / etiology*
  • Pain / psychology
  • Pain Management / methods
  • Parturition / psychology*
  • Perineum / injuries*
  • Perineum / physiopathology
  • Pregnancy